The relationship between cumulative dose of immunosuppressive agents and COVID‐19‐associated mucormycosis: A multicenter cross‐sectional study. Issue 6 (22nd November 2022)

• Record Type: Journal Article
• Authors: Rastkar, Mohsen; SeyedAlinaghi, SeyedAhmad; Asanjarani, Behzad; Siri, Goli; Abdollahi, Hamed; Ghadami, Ladan; Hasibi, Mehrdad; Khodashahi, Rozita; Bagheri, AmirBehzad; Asadollahi‐Amin, Ali
• Is Part Of: Health science reports. Volume 5:Issue 6(2022)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2022-11-22
• Subjects: corticosteroids -- COVID‐19 -- immunosuppressive -- mucormycosis -- outcome -- tocilizumab; 610
• DOI: 10.1002/hsr2.950
• Languages: English
• ISSNs: 2398-8835

Abstract

Abstract: Background and Aims: Immunosuppressive therapy has a key role in developing coronavirus disease‐2019 (COVID‐19)‐associated mucormycosis. In this study, we investigated the effect of the type and cumulative dose of immunosuppressive agents on COVID‐19‐associated mucormycosis. Methods: We designed a descriptive cross‐sectional study involving three COVID‐19 hospitals in Iran. Clinical and demographic data were gathered from the medical records and checked by two independent researchers to minimize errors in data collection. Results: Seventy‐three patients were included in the study. The mean age of cases was 57.41 (SD = 12.64) and 43.8% were female. Among patients, 20.5% were admitted to the intensive care unit (ICU) during COVID‐19. Furthermore, 17 patients (23.29%) had a history of diabetes mellitus. Sixty‐nine patients (94.52%) had a history of receiving corticosteroids (dexamethasone) during treatment of COVID‐19, and of those, five patients (6.85%) received Tocilizumab beside. The mean cumulative dose of corticosteroids prescribed was 185.22 mg (SD = 114.738). The average cumulative dosage of tocilizumab was 720 mg (SD = 178.89). All of the included patients received amphotericin B for mucormycosis treatment, and 42 survived (57.53%). Also, there was a significant relationship between hospitalization in ICU for COVID‐19 and the mucormycosis outcome ( p = 0.007). However, there weren't any significant associations between cumulative doses of immunosuppressive drugs and mucormycosis outcome ( p = 0.52). Conclusion: The prevalence of COVID‐19‐associated mucormycosis is increasing and should be considered in the treatment protocols of COVID‐19. Controlling risk factors such as diabetes, malignancy and the administration of immunosuppressive agents based on recommended dosage in validated guidelines are ways to prevent mucormycosis.